System and method of laparoscopic use of hemostatic patch

ABSTRACT

The present disclosure includes systems and a method for in situ application of a surgical patch during minimally invasive surgery. The method includes the steps of inserting a surgical patch into a bag; transferring a polymeric bag containing a hemostatic patch into a body cavity; removing the surgical patch from the polymeric bag while the polymeric bag is within the body cavity; and applying the surgical patch to a tissue within the body cavity.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.12/791,534 filed Jun. 1, 2010, which claims benefit of and priority toU.S. Provisional Application No. 61/229,333 filed Jul. 29, 2009, and thedisclosures of each of the above-identified applications are herebyincorporated by reference in their entirety.

BACKGROUND

Technical Field

The present disclosure relates to apparatus and methods for theapplication of a surgical patch. More particularly, the presentdisclosure relates to systems and methods for the in situ application ofa surgical patch during minimally invasive surgery.

Background

Surgical patches, such as hemostatic patches, are used in repair ofdefective tissues or organs to establish hemostasis. Hemostatic patchescan be used as a supplement to or in conjunction with sutures, staples,or other medical attachment or fastening devices. Hemostatic patches canbe used to provide hemostasis to the tissue or organ in need oftreatment.

Self-affixing surgical patches are useful for application during opensurgery where the surgical patch is applied in the form, i.e., shape, inwhich it is packaged. However, certain types of absorbable medicaldevices may be moisture sensitive, that is, they will prematurely reactif exposed to moisture in the atmosphere or in the body. Therefore, anapparatus and method of transporting these patches without exposure toambient or interstitial moisture is needed.

SUMMARY

The present disclosure is directed to the application of a surgicalpatch during minimally invasive surgery. The method includeslaparoscopically transferring a polymeric bag containing a surgicalpatch into a body cavity followed by removing said surgical patch fromthe polymeric bag within the body cavity, and applying said surgicalpatch to a site in the body cavity in need of hemostasis. The method mayalso include the step of providing a hemostatic patch. The hemostaticpatch may include a substrate having a first hydrogel precursor appliedto a first portion of the substrate; and a second hydrogel precursorapplied to a second portion of the substrate. The method may alsoinclude the step of providing a polymeric bag comprising a materialselected from polyurethane and latex.

In another embodiment the surgical patch is transferred to a polymericbag. The polymeric bag containing the surgical patch is thenlaparoscopically transferred into a body cavity. This embodiment mayfurther include providing a hemostatic patch. The hemostatic patch mayinclude a substrate having a first hydrogel precursor applied to a firstportion of the substrate; and a second hydrogel precursor applied to asecond portion of the substrate. The polymeric bag may include amaterial selected from polyurethane and latex.

The present disclosure further includes an apparatus for transferring anitem into a body cavity during laparoscopic surgery. The apparatus mayinclude a surgical patch in a polymeric bag sized and dimensioned to bereceived within a deployment device.

The present disclosure is also directed to an apparatus for performing asurgical procedure. The apparatus includes: an elongated tube; a driverod; a spring; and a surgical patch received with a polymeric bag. Thedrive rod, spring, and surgical patch are slidably housed within theelongated tube. The distal end of the drive rod may be connected to thespring. The proximal end of the drive rod may include a handle.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing objects and advantages of the disclosure will become moreapparent from the reading of the following description in connectionwith the accompanying drawings, in which:

FIG. 1 is a perspective view of a laparoscopic deployment device, shownin a non-deployed condition, in accordance with the present disclosure;

FIG. 2 is an illustration of a hemostatic patch in accordance with thepresent disclosure;

FIG. 3 is an illustration of a hemostatic patch retained within apolymeric bag in accordance with the present disclosure;

FIGS. 4A-4B are a schematic illustration of the effect of fluid on thehemostatic patch in situ in accordance with the present disclosure; and

FIGS. 5A-5D are schematic illustrations of the use of the laparoscopicdeployment device of FIG. 1 deploying the hemostatic patch retainedwithin a bag of FIG. 2 in accordance with the present disclosure.

DETAILED DESCRIPTION

The present disclosure relates to devices, systems and methods forminimally invasive surgeries such as, endoscopic, laparoscopic,arthroscopic, endoluminal and/or transluminal placement of a surgicalpatch at a surgical site. As used herein the term “surgical patch” isused to refer to any type of patch for use in surgical procedures, suchas, for example, patches that react in situ and those that react uponexposure to moisture. As used herein the term “laparoscopic deploymentdevice” is used to refer to a deployment device that may be used duringminimally invasive surgeries described above.

In the drawings and in the description that follows, the term“proximal,” as is traditional, will refer to an end of a device that iscloser to the user, while the term “distal” will refer to the end of thedevice that is further from the user.

Laparoscopic surgical procedures are minimally invasive procedures whichare carried out within the body cavity through use of access ports inconjuncture with elongated surgical devices. An initial opening in thebody tissue enables passage of the endoscopic or laparoscopic device tothe interior of the body. Openings include natural passageways of thebody or openings which are created by a tissue piercing device such as atrocar. During laparoscopic procedures, narrow punctures or incisionsare made minimizing trauma to the body cavity and reducing patientrecovery time.

Referring now in specific detail to the drawings, in which like numbersidentify similar or identical elements, FIG. 1 illustrates alaparoscopic deployment/collection device and is generally designated as100. The deployment device 100 includes an elongated tube 102, which isof such dimensions and/or diameter to be insertable through an accessdevice, such as a trocar cannula, for endoscopic or laparoscopicprocedures. The tube 102 is generally between about 0.25 inches to 0.50inches in diameter, and about 10 inches to about 15 inches long,although other dimensions may also be used if appropriate. Tube 102slidably houses a drive rod 104 and, when undeployed, a polymeric bag60, containing a surgical patch 10.

The laparoscopic deployment device 100 includes a drive rod or bar 104that is an elongated generally cylindrical member slidably disposedthrough the bore of tube 102. A distal end of the drive rod 104 isattached to the bag 60 to move the bag 60 from a non-deployed positioncontained within the outer tube 102 to a deployed position distal to theouter tube 102.

A locking tab 106 may be included to prevent premature actuation of thedevice. The locking tab 106 includes snap fit engagement structure toengage a slot of the drive rod 104. When thus engaged, the drive rod 104cannot be pushed distally beyond the point where the locking tab 106engages the proximal end of handle portions 108, 110.

In addition, the laparoscopic deployment device 100 may include a fingerloop 114 for engagement by a user's finger. One end of a drawstring 116is attached to the finger loop 114 while an opposing end of thedrawstring 116 is attached to the bag 60. In an initial, unusedcondition, bag 60 will be rolled up (or otherwise folded) and contain aspring 112 and surgical patch 10 in a relatively straight positionwithin tube 102. When the drive rod 104 is advanced, the spring 112connected thereto will exit a distal end of tube 102 and resilientlyopen, thereby deploying and opening the bag 60 to allow access to thesurgical patch 10. In some embodiments the bag 60 will remain closedfollowing deployment. Tube 102 is preferably formed from a metal such asstainless steel and is preferably coated with a shrink-wrap plastic suchas shrinkable polyethylene fiberglass, or polyvinyl chloride of a gradesuitable for use in surgical procedures.

Such devices are known in the art and include, for example, the devicesdisclosed in U.S. Patent Application Publication No. 2006/0229640, filedMar. 29, 2005; U.S. Patent Application Publication No. U.S.2006/0200170, filed Mar. 7, 2005; and U.S. Patent ApplicationPublication No. 2006/0200169, filed Mar. 7, 2005, the entire contents ofwhich are incorporated by reference herein.

FIG. 2 illustrates one embodiment of a surgical patch, according to thepresent disclosure. A hemostatic patch 11 is used with laparoscopicdeployment device 100. The hemostatic patch 11 includes a poroussubstrate 20 having a first hydrogel precursor 30 applied to a firstportion 22 of the porous substrate and a second hydrogel precursor 40applied to a second portion 24 of the porous substrate. Such ahemostatic patch 11 is disclosed in U.S. Provisional Patent ApplicationNo. 61/196,543, filed Oct. 17, 2008, the entire contents of which areincorporated by reference herein.

During use, the hemostatic patch 11 is oriented with the portion 24 towhich the second hydrogel precursor 40 is applied being closer to thetissue and the portion 22 having the first hydrogel precursor 30 appliedthereto further from the tissue. In embodiments, the first and secondportions 22, 24 may be distinguishable from one another by the additionof contrast dyes, surface texturing, coloring or other visual cues. Uponcontact with tissue, such as, for example, injured tissue, thehemostatic patch 11 will soak up physiological fluid and the secondhydrogel precursor 40 may be dissolved by the fluid. As the fluid wicksinto and migrates across the hemostatic patch 11, it will carry thedissolved second hydrogel precursor 40 along through the hemostaticpatch 11. Eventually, the fluid will migrate through the hemostaticpatch 11 sufficiently to reach the portion 22 to which the firsthydrogel precursor 30 is applied, thereby contacting the first hydrogelprecursor 30. The first and second hydrogel precursors 30, 40 will thenreact to form a biocompatible cross-linked material, thereby creatinghemostasis at the injury site. In some embodiments, the biocompatiblecross-linked material produced by reaction of the first and secondhydrogel precursors 30, 40 not only provide hemostatic properties butalso provide a portion of the hemostatic patch 11 with anti-adhesiveproperties.

The porous substrate 20 of the hemostatic patch 11 has openings or poresover at least a portion of a surface thereof. The pores may be formed inthe substrate either before or after implantation. As described in moredetail below, suitable materials for forming the porous substrate 20include, but are not limited to fibrous structures (e.g., knittedstructures, woven structures, non-woven structures, etc.) and/or foams(e.g., open or closed cell foams). In embodiments, the pores may be insufficient number and size so as to interconnect across the entirethickness of the porous substrate 20. Woven fabrics, kitted fabrics andopen cell foam are illustrative examples of structures in which thepores can be in sufficient number and size so as to interconnect acrossthe entire thickness of the porous substrate 20. In embodiments, thepores do not interconnect across the entire thickness of the poroussubstrate 20. Closed cell foam or fused non-woven materials areillustrative examples of structures in which the pores may notinterconnect across the entire thickness of the porous substrate 20. Thepores of the foam porous substrate 20 may span across the entirethickness of porous substrate 20. In yet other embodiments, the pores donot extend across the entire thickness of the porous substrate 20, butrather are present at a portion of the thickness thereof. Inembodiments, the openings or pores are located on a portion of thesurface of the porous substrate 20, with other portions of the poroussubstrate 20 having a non-porous texture. In other embodiments, thepores may be formed after implantation in situ. The in situ poreformation may be performed using any suitable method. Some non-limitingexamples include the use of contact lithography, living radicalphotopolymer (LRPP) systems and salt leaching. Those skilled in the artreading the present disclosure will envision other pore distributionpatterns and configurations for the porous substrate 20.

Where the porous substrate 20 is fibrous, the fibers may be filaments orthreads suitable for knitting or weaving or may be staple fibers, suchas those frequently used for preparing non-woven materials. The fibersmay be made from any biocompatible material. Thus, the fibers may beformed from a natural material or a synthetic material. The materialfrom which the fibers are formed may be bioabsorbable ornon-bioabsorbable. It should be understood that any combination ofnatural, synthetic, bioabsorbable and non-bioabsorbable materials may beused to form the fibers. Some non-limiting examples of materials fromwhich the fibers may be made include, but are not limited to polyesterssuch as poly(lactic acid) and poly(glycolic acid) poly(trimethylenecarbonate), poly (dioxanone), poly (hydroxybutyrate), poly(phosphazine), polyethylene terephthalate, ultra-high molecular weightpolyethylene, polyethylene glycols, polyethylene oxides,polyacrylamides, polyhydroxyethylmethylacrylate (pHEMA),polyvinylpyrrolidone, polyvinyl alcohols, polyacrylic acid, polyacetate,polycaprolactone, polypropylene, aliphatic polyesters, glycerols,poly(amino acids), copoly (ether-esters), polyalkylene oxalates, poly(saccharides), polyamides, poly (iminocarbonates), polyalkyleneoxalates, polyoxaesters, polyorthoesters, polyphosphazenes, biopolymers,polymer drugs and copolymers, block copolymers, homopolymers, blends andcombinations thereof.

Where the porous substrate 20 is fibrous, the porous substrate 20 may beformed using any method suitable to forming fibrous structures,including but not limited to knitting, weaving, non-woven techniques,wet-spinning, electro-spinning, extrusion, co-extrusion, and the like.Suitable techniques for making fibrous structures are within the purviewof those skilled in the art. In embodiments, the textile has a threedimensional structure, such as the textiles described in U.S. Pat. Nos.7,021,086 and 6,443,964, the contents of which are incorporated byreference herein.

In some embodiments, the porous substrate 20 is made from fibers ofoxidized cellulose. Such materials are known and include oxidizedcellulose hemostat materials commercially available under the trade nameSURGICEL®. Methods for preparing oxidized cellulose hemostat materialsare known to those skilled in the art and are disclosed, for example inU.S. Pat. Nos. 3,364,200; 4,626,253; 5,484,913; and 6,500,777, thedisclosures of which are incorporated herein by this reference in theirentirety.

Where the porous substrate 20 is a foam, the porous substrate 20 may beformed using any method suitable to forming a foam or sponge including,but not limited to the lyophilization or freeze-drying of a composition.The foam may be cross-linked or non-cross-linked, and may includecovalent or ionic bonds. Suitable techniques for making foams are withinthe purview of those skilled in the art.

As mentioned above, the porous substrate 20 has a first and secondhydrogel precursor 30, 40 applied thereto. The terms “first hydrogelprecursor” and “second hydrogel precursor” each mean a polymer,functional polymer, macromolecule, small molecule, or crosslinker thatcan take part in a reaction to form a network of crosslinked molecules,e.g., a hydrogel.

In embodiments, each of the first and second hydrogel precursors 20, 30,includes only one category of functional groups, either onlynucleophilic groups or only electrophilic functional groups, so long asboth nucleophilic and electrophilic precursors are used in thecrosslinking reaction. Thus, for example, if the first hydrogelprecursor 30 has nucleophilic functional groups such as amines, thesecond hydrogel precursor 40 may have electrophilic functional groupssuch as N-hydroxysuccinimides. On the other hand, if first hydrogelprecursor 30 has electrophilic functional groups such assulfosuccinimides, then the second hydrogel precursor 40 may havenucleophilic functional groups such as amines or thiols. Thus,functional polymers such as proteins, poly(allyl amine), styrenesulfonic acid, or amine-terminated di- or multifunctional poly(ethyleneglycol) (“PEG”) can be used.

The first and second hydrogel precursors 30, 40 may have biologicallyinert and water soluble cores. When the core is a polymeric region thatis water soluble, preferred polymers that may be used include:polyether, for example, polyalkylene oxides such as polyethylene glycol(“PEG”), polyethylene oxide (“PEO”), polyethylene oxide-co-polypropyleneoxide (“PPO”), co-polyethylene oxide block or random copolymers, andpolyvinyl alcohol (“PVA”); poly(vinyl pyrrolidinone) (“PVP”); poly(aminoacids); poly (saccharides), such as dextran, chitosan, alginates,carboxymethylcellulose, oxidized cellulose, hydroxyethylcellulose,hydroxynethylcellulose, hyaluronic acid, and proteins such as albumin,collagen, casein, and gelatin. The polyethers and more particularlypoly(oxyalkylenes) or poly(ethylene glycol) or polyethylene glycol areespecially useful. When the core is small molecular in nature, any of avariety of hydrophilic functionalities can be used to make the first andsecond hydrogel precursors 30, 40 water soluble. For example, functionalgroups like hydroxyl, amine, sulfonate and carboxylate, which are watersoluble, maybe used to make the precursor water soluble. In addition,N-hydroxysuccinimide (“NHS”) ester of subaric acid is insoluble inwater, but by adding a sulfonate group to the succinimide ring, the NHSester of subaric acid may be made water soluble, without affecting itsreactivity towards amine groups.

The first and second hydrogel precursors 30, 40 may be applied to theporous substrate 20 using any suitable method known to those skilled inthe art. For example, the first and second hydrogel precursors 30, 40,may be incorporated into the porous substrate 20 prior to forming theporous substrate 20. In another non-limiting example, the first orsecond hydrogel precursors 30, 40 may be positioned in the pores of theporous substrate 20 or onto a surface of the porous substrate 20following formation of the substrate. In additional embodiments, theporous substrate 20 may be calendered prior to application of the firsthydrogel precursor 30 thereby allowing the first or second hydrogelprecursors 30, 40 to penetrate into openings on the substrate which werecreated by the calendaring process.

In other embodiments, the first or second hydrogel precursors 30, 40 maybe in the form of a coating which is applied to the substrate in anyconcentration, dimension and configuration capable of forming thehemostatic patch 11. The coating may form a non-porous layer or a porouslayer. In embodiments, at least one of the first and second hydrogelprecursors 30, 40 is a cross-linker. In embodiments, at least one of thefirst and second hydrogel precursors 30, 40 is a macromolecule, and isreferred to as a “functional polymer”.

Each of the first and second hydrogel precursors 30, 40 ismultifunctional, meaning that it comprises two or more electrophilic ornucleophilic functional groups, such that, for example, a nucleophilicfunctional group on the first hydrogel precursor 30 may react with anelectrophilic functional group on the second hydrogel precursor 40 toform a covalent bond. At least one of the first or second hydrogelprecursors 30, 40 includes more than two functional groups, so that, asa result of electrophilic-nucleophilic reactions, the precursors combineto form cross-linked polymeric products.

In embodiments, a multifunctional nucleophilic polymer such as trilysinemay be used as a first hydrogel precursor 30 and a multifunctionalelectrophilic polymer such as a multi-arm PEG functionalized withmultiple NHS groups may be used as a second hydrogel precursor 40. Themulti-arm PEG functionalized with multiple NHS groups can for examplehave four, six or eight arms and have a molecular weight of from about5,000 to about 25,000. Many other examples of suitable first and secondhydrogel precursors 30, 40 are described in U.S. Pat. Nos. 6,152,943;6,165,201; 6,179,862; 6,514,534; 6,566,406; 6,605,294; 6,673,093;6,703,047; 6,818,018; 7,009,034; and 7,347,850, the entire content ofeach of which is incorporated herein by reference.

While the present disclosure may involve a hemostatic patch, anysurgical patch may be used in the method disclosed herein. Thehemostatic patch may be any size and dimension capable of transport inthe laparoscopic deployment device of the disclosure. In one embodiment,the hemostatic patch is about 2 inches square, although it is envisionedthat the patch may be of varying shapes and sizes. Additionally, whilethe substrate used in forming the patch is described as “porous” thesubstrate may be porous or non-porous in various embodiments.

Upon application to a site of bleeding tissue, the hemostatic patch mayaffect hemostasis of said tissue. As used herein, the term “hemostasis”means the arrest of bleeding. It is believed, without being limitedthereto, that the hemostatic effect of the hemostatic patch is due toboth intrinsic and extrinsic factors. In some embodiments, the substratemay be comprised of a hemostatic agent providing an intrinsic hemostaticeffect. In embodiments, the cross-linking between the hydrogelprecursors creates a physical barrier to blood flow providing anextrinsic hemostatic effect. Hemostasis may occur, at the site ofapplication of the hemostatic patch, within less than about 2 minutes.As stated above, upon contact with tissue, such as, for example, injuredor bleeding tissue, the hemostatic patch 11 soaks up interstitial andphysiological fluid (e.g., blood, lymph-fluid, etc.) and the first andsecond hydrogel precursors 30, 40 are mixed by the fluid. In order toprevent the hemostatic patch 11 from taking up fluid prior to use at thelocation in need of hemostasis, the hemostatic patch 11 is retained orsealed in packaging until the time it is needed for its application.

As shown in FIG. 3, to provide for moisture resistant transport of thehemostatic patch 11 during laparoscopic surgery, the hemostatic patch 11is enclosed in a polymeric bag 60, which is moisture resistant. The term“moisture” as used herein means physiological fluids and humidity. Asused herein, the term “sterile” means that the bag is free from livingorganisms such as microorganisms in addition to endotoxins, viruses, andthe like. The bag 60 may be formed of material that resistsmoisture/humidity. Exemplary materials which may be used in accordancewith the present disclosure include, for example, a substantiallytransparent polymeric material such as a polyurethane sheet or latex. Inembodiments, the bag 60 may include a metallized layer disposed on aplastic film backing in order to reduce the incidence and degree ofporosity thereof. In one embodiment, the bag 60 is formed from aromaticpolyester type thermoplastic polyurethane such as Dureflex®, a productof Deerfield Urethane, Inc., located in Whately, Mass. In someembodiments, the bag 60 is transparent to permit viewing of thehemostatic patch 10. The thickness of the bag 60 can be from about 0.001to about 0.005 inches although other thicknesses are also envisioned.The bag 60 should also be impervious to penetration by disease-causingcells, such as cancer cells. The bag 60 may be of any dimension suitableto enclose the hemostatic patch 11, and prevent the hemostatic patchfrom contacting moisture. The bag 60 may be folded or rolled to a sizesufficient to be inserted into the laparoscopic deployment device 100.In some embodiments, the bag 60 may have a diameter from about 1.5inches to about 6.0 inches, a depth of from about 2 inches to about 10inches, and a cubic capacity of up to about 2.0 liters of water. In someembodiments, the bag 60 is an Endobag™ manufactured by Covidien AG,Mansfield, Mass. As seen in FIG. 3, hemostatic patch 11 may be rolled orfolded for placement within bag 60. In some embodiments, when folded orrolled, the hemostatic patch 11, in the bag 60, is preferably less thanabout 0.50 inches in diameter. In another embodiment, the rolled orfolded hemostatic patch 11, in the bag 60, is less than about 0.25inches in diameter.

The polymeric bag 60 may be sealed in such a manner as to protect thehemostatic patch 11 from exposure to moisture during and afterdeployment thereof from a laparoscopic device 100. In embodiments, thebag 60 may be open following deployment from the device.

The hemostatic patch 11, in the sterile polymeric bag 60, may betransferred to a body cavity during laparoscopic surgery utilizinglaparoscopic deployment device 100. As seen in FIGS. 4A-4B, during use,the hemostatic patch 11 is oriented with second portion 24, to which thesecond hydrogel precursor 40 is applied, being closer to tissue 50 andwith the first portion 22, to which the first hydrogel precursor 30 isapplied, being disposed further from the tissue 50. Upon contact withtissue 50, such as, for example, injured or bleeding tissue, hemostaticpatch 11, soaks up physiological fluid or blood 26 and the secondportion 24, having the second hydrogel precursor 40, is dissolved by thefluid or blood 26. As the fluid or blood 26 wicks into and migratesacross the hemostatic patch 11, the fluid or blood carries the dissolvedsecond hydrogel precursor 40 along through the hemostatic patch 11sufficiently to reach the first portion 22 to which the first hydrogelprecursor 30 is applied, thereby initiating the cross-linking reactionbetween the first and second hydrogel precursors 30, 40. At this point,as seen in FIG. 4B, first and second hydrogel precursors 30, 40, thenreact to form a biocompatible cross-linked material 28 thereby assistingwith the hemostasis of the tissue 50.

In one embodiment, the laparoscopic deployment device 100 may containthe hemostatic patch 11 encased in the polymeric bag 60 for deliveryduring a single use of the laparoscopic deployment device. In anotherembodiment, a hemostatic patch 11, encased in the polymeric bag 60, maybe provided for insertion into a laparoscopic deployment device 100.

According to another method of use, as shown in FIGS. 5A-5C, alaparoscopic deployment device 100 is shown inserted into a body cavity400 through a trocar 402 and additional trocar 406 is inserted in theside of the body cavity 400, for later use. As shown in FIGS. 5A-5B,locking tab 106 is removed and drive rod 104 is pushed to the proximalend of handle portions 108, 110. As seen in FIG. 5B, the hemostaticpatch 11, encased in the polymeric bag 60 is deployed though thelaparoscopic deployment device 100 into the body cavity 400. At thispoint, as seen in FIG. 5C, the encased hemostatic patch 11 can then beremoved from laparoscopic deployment device 100 using pinchers 408through trocar 406 and held to the side of the body cavity 400 as shownin FIG. 5D, until needed. At the point in time of theprocedure/operation, when the hemostatic patch 11 is needed, variouslaparoscopic tools known to those skilled in the art can be utilized toremove the hemostatic patch 11 from the polymeric bag 60 and place thehemostatic patch 11 in the location it is needed or desired, e.g., theinjured or bleeding tissue.

While the above description contains many specifics, these specificsshould not be construed as limitations on the scope of the presentdisclosure, but merely as exemplifications of preferred embodimentsthereof. Those skilled in the art will envision many other possiblevariations that are within the scope and spirit of the presentdisclosure.

What is claimed is:
 1. An apparatus for delivering a surgical patch intoa body cavity during laparoscopic surgery, the apparatus comprising: asurgical patch including a first hydrogel precursor and a secondhydrogel precursor on the first hydrogel precursor, the first hydrogelprecursor including one of nucleophilic functional groups orelectrophilic functional groups, and the second hydrogel precursorincluding the other of the nucleophilic functional groups or theelectrophilic functional groups, the first and second hydrogelprecursors configured to react with one another to form a biocompatiblecross-linked material; and a polymeric bag, the surgical patch disposedin the polymeric bag, the surgical patch and polymeric bag configured tobe received within a deployment device for delivering the surgical patchand the polymeric bag into a body cavity.
 2. The apparatus according toclaim 1, wherein the polymeric bag and the surgical patch are configuredto be delivered together into the body cavity.
 3. The apparatusaccording to claim 2, wherein the surgical patch is selectivelyremovable from the polymeric bag while the surgical patch and thepolymeric bag are within the body cavity.
 4. The apparatus according toclaim 1, wherein the surgical patch is configured to wick fluid formigration across the surgical patch to enable the first and secondhydrogel precursors to react with one another.
 5. The apparatusaccording to claim 1, wherein the surgical patch is sealed inside thepolymeric bag.
 6. A system for performing a surgical procedure, thesystem comprising: a polymeric bag; a surgical patch within thepolymeric bag, the surgical patch including a first hydrogel precursorand a second hydrogel precursor on the first hydrogel precursor, thefirst hydrogel precursor including one of nucleophilic functional groupsor electrophilic functional groups, and the second hydrogel precursorincluding the other of the nucleophilic functional groups or theelectrophilic functional groups, the first and second hydrogelprecursors configured to react with one another to form a biocompatiblecross-linked material; and a deployment device including: an elongatedtube; and a drive rod supported within the elongated tube and slidableto advance the polymeric bag and surgical patch along the elongated tubeto dispense the polymeric bag and surgical patch from the elongatedtube.
 7. The system according to claim 6, wherein the drive rod isconnected to a spring.
 8. The system according to claim 6, wherein thedrive rod includes a handle.
 9. The system according to claim 6, whereinthe surgical patch comprises: a substrate having the first hydrogelprecursor applied to a first portion of the substrate; and the secondhydrogel precursor applied to a second portion of the substrate.
 10. Thesystem according to claim 9, wherein the first and second hydrogelprecursors are configured to react with one another to form abiocompatible cross-linked material while the surgical patch ispositioned in a body cavity.
 11. The system according to claim 10,wherein the surgical patch is configured to wick fluid for migrationacross the surgical patch to enable the first and second hydrogelprecursors to react with one another.
 12. The system according to claim6, wherein the surgical patch is sealed inside the polymeric bag. 13.The system according to claim 6, wherein the polymeric bag isconstructed, at least in part, from polyurethane.
 14. The systemaccording to claim 6, wherein the surgical patch is rolled or foldedwithin the polymeric bag.
 15. The system according to claim 9, whereinthe substrate is nonporous.
 16. The system according to claim 9, whereinthe substrate is porous.